Elsayes Salma A, El Attar Mohamed Sherine, ElHadary Amany, Aboulela Aliaa Gamaleldin, Essawy Marwa M, Soliman Ingy S
Postgraduate student, Department of Prosthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
Professor, Department of Prosthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
J Prosthet Dent. 2024 Jun 20. doi: 10.1016/j.prosdent.2024.05.018.
Changes in the oral microbiota of new complete denture wearers are the main cause of oral candidiasis. The drawbacks associated with traditional antimycotic therapies, especially drug resistance, have led to the search for potent therapeutic and prophylaxis agents with less harmful effects, including probiotics. However, investigation of the prophylaxis and preventive effects of probiotics on new complete denture wearers are lacking.
The purpose of this randomized clinical trial was to assess the prophylactic efficiency of multistrain probiotics (Lactobacillus and Bifidobacterium) in combating oral candidiasis in new complete denture wearers. The Candida relapse after 4 weeks of intervention cessation was also evaluated.
A total of 50 new maxillary and mandibular complete denture wearers with asymptomatic detectable levels of Candida were enrolled. The participants in the probiotics group received a daily dose of probiotic lozenges for 8 weeks versus placebo tablets taken by those in the placebo group. Collected mouth-rinse samples were microbiologically assessed to count Candida colonies and identify different species at different time intervals: baseline, 2 weeks after denture delivery, 4 and 8 weeks after the beginning of intervention, and 4 weeks postintervention follow-up. Data were assessed by performing the Shapiro-Wilk test to check the normality of the colony count, while the difference in the colony count between timelines was analyzed using the Freidman test followed by multiple comparison tests (α=.05).
Two weeks after denture delivery, the Candida load had not risen significantly from the baseline count (P>.05). After the intervention, the probiotics had reduced the Candida count significantly in the fourth week and in subsequent follow-up periods, with the highest decrease observed in the eighth week, recording a median count of (0.00) compared with (2.74) at the baseline level (P<.001). Furthermore, in assessing the differential count of Candida species, a noteworthy decrease was found in the level of the most prevalent Candida albicans in the eighth week, with a relapse noticed in the twelfth week of posttreatment follow-up.
Probiotic lozenges had antimycotic efficiency in asymptomatic new complete denture wearers, with short-term extended preventive effects after intervention cessation.
新全口义齿佩戴者口腔微生物群的变化是口腔念珠菌病的主要原因。传统抗真菌疗法的缺点，尤其是耐药性，促使人们寻找具有较小有害影响的有效治疗和预防药物，包括益生菌。然而，目前缺乏关于益生菌对新全口义齿佩戴者的预防和预防效果的研究。
本随机临床试验的目的是评估多菌株益生菌（乳酸杆菌和双歧杆菌）在对抗新全口义齿佩戴者口腔念珠菌病方面的预防效果。还评估了干预停止4周后念珠菌的复发情况。
共招募了50名新佩戴上颌和下颌全口义齿且念珠菌检测水平无症状的患者。益生菌组的参与者每天服用一剂益生菌含片，持续8周，而安慰剂组的参与者服用安慰剂片。收集漱口样本进行微生物学评估，以计算念珠菌菌落数，并在不同时间间隔识别不同物种：基线、义齿交付后2周、干预开始后4周和8周，以及干预后随访4周。通过进行Shapiro-Wilk检验来检查菌落计数的正态性，同时使用Friedman检验分析不同时间线之间菌落计数的差异，随后进行多重比较检验（α = 0.05）。
义齿交付后2周，念珠菌载量与基线计数相比没有显著增加（P > 0.05）。干预后，益生菌在第四周及随后的随访期显著降低了念珠菌计数，第八周下降最为明显，中位数计数为（0.00），而基线水平为（2.74）（P < 0.001）。此外，在评估念珠菌物种的差异计数时，发现最常见的白色念珠菌水平在第八周有显著下降，在治疗后随访的第十二周出现复发。
益生菌含片对无症状的新全口义齿佩戴者具有抗真菌效果，干预停止后具有短期的延长预防作用。
